The five interrelated projects are: (1) Cardiac assist devices and revascularization of the myocardium; (2) the total artificial heart; (3) its pathophysiological effects; (4) hematological studies; and (5) new materials. Closed chest left ventricular bypass is now being followed by open chest transapical bypass. Perfusion of the specific vein that drains an ischemic area of the myocardium provides the necessary blood supply. How practical may it become? New blood vessels have been created by growing them on skeletons of special porous Teflon. Future patients will progress from cardiac assist devices to the artificial heart. Our artificial hearts are driven by compressed air. There are no electronic controls inside the chest, yet they respond to Starling's Law. The peripheral neurovascular mechanism and the overall control system suffice for the physiological responses of the circulation. Limiting factors are recognized and eliminated - result: the world's record of survival of a calf with an artificial heart for almost 19 days. Intima with fibril coating greatly diminished disseminated intravascular coagulation. Its pathogenesis is further defined and the fate of radiolabeled thrombocytes is being pursued. Respiratory distress syndrome may or may not be the pulmonary equivalent of DIC. The syndrome of right heart failure has been largely overcome by better fitting (Jarvik) artificial hearts and will be further reduced with better valves and compliant atria. Reduction of hemolysis may lead to elimination of hemolytic icterus. Polyurethanes hold on better to fibrils than Silastic and polyurethane will be provided with foam surfaces. Our ultimate goal is to gain information to build artificial hearts which will ultimately replace the ailing human heart.